Strengths
This study carries several strengths. The study design is community
based and systematically represent more than 80% of pregnant women
newly registered in Anuradhapura, the largest district of Sri Lanka. The
study represent a rural population. The results depict follow up of a
cohort of pregnant women. Hence the prospective nature implies in
prediction of the direction of the association between NAFLD and GDM. We
have used the latest WHO criteria for the assessment of GDM. The study
has clearly excluded pregnant women who have had all types of
hyperglycaemia. Hence the clarity of the association is strong. In
addition identification of NAFLD and GDM were performed using
measurements adopted to standard protocols.